Drug card plan raises concerns about hurting pharmacies

Lawmakers are focusing on Medicare Rx deals involving manufacturers and pharmacy benefit managers, but pharmacists worry they'll pay the price.

By Markian Hawryluk, AMNews staff. Nov. 12, 2001.

Washington -- Proponents of a Medicare drug benefit are keeping an eye on the debate over President Bush's proposed prescription discount cards because both measures face similar hurdles.

After a legal setback delayed introduction of the cards, Medicare officials are now looking to Congress to grant them the authority to proceed with the plan. Opponents of the proposal, however, say the drug cards will provide limited relief to seniors and will hurt local pharmacies.

At issue is the source of the discount. While the drug cards are intended to provide savings through bulk purchasing, pharmacy owners are concerned the discounts will be taken out of their profits.

At a recent hearing of the House Small Business Committee, Gary Sims, owner of four West Virginia pharmacies, said his state introduced the Golden Mountaineer discount card with great fanfare, but in the end, the pharmacy benefits manager running the program profited at the expense of the local pharmacies.

"Because my cost to buy the drug is still the same, I am receiving no reduction in the cost," Sims said. "In fact, it costs me more to fill the prescription because I now must submit an electronic claim to the PBM and I must pay a fee for every prescription that is filled."

Rep. Nancy Johnson (R, Conn.), chair of the House Ways and Means health subcommittee, said she would like to see a bill allowing the Centers for Medicare & Medicaid Services to introduce the cards, but she also wants protections for pharmacies.

"If you were going to authorize that legislatively, you'd also have to include in that authorization some description of the system so that the pharmacists know that they're going to be able to deliver the product at the price that the PBMs propose," Johnson said. "And frankly, I haven't figured that out yet." [...]